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Anticoagulation and GI bleeding
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Warfarin indirectly inhibits the synthesis of factors II, VII, IX, and X via inhibition of VKORC1.
The direct thrombin (dabigatran) and direct factor Xa (apixaban, betrixaban, edoxaban, and rivaroxaban) inhibitors VKORC1, vitamin K epoxide reductase complex subunit 1.
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NOAC and GI bleeding
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novel oral anticoagulants
Dabigatran (Pradaxa) Rivaroxaban (Xarelto) Apixaban (Eliquis) Edoxaban (Lixiana) Mechanism of action Anti-thrombin Anti-factor Xa Bioavailability 7% 66% 50% 60% Tmax (h) 1.5 2.5 3 1-5 T½ (h) 9-17 6-13 12 Dosing b.i.d once daily Renal excretion High Moderate Hepatic metabolism Low Reversal agents Idarucizumab Andexanet alfa Aripazine
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DOAC 와파린과 비교해서 위장관 출혈에 대한 위험도를 25-30% 정도 증가
위장관 안전성: apixaban > dabigatran > rivaroxaban 생체이용률의 차이? 투약방법의 차이?
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